In its mission to simplify the complex payment and bidding process that plagues the prescription drug benefits industry, today Truveris, Inc. announced it closed a $10M oversubscribed Series B round of venture funding, led by New Leaf Venture Partners and joined by Tribeca Venture Partners, New Atlantic Ventures and First Round Capital.
Since securing its Series A round of institutional capital a year ago, Truveris launched TruGuard and TruBid, which drive efficiency, transparency and cost containment for its 11 million participants in the prescriptions claims process. Additionally, Truveris recruited a deep bench of industry veterans that previously held executive roles at Medco Health Solutions (NYSE: MHS), Empire Blue Cross Blue Shield, Oxford Health Plans, CVS Caremark (NYSE: CVS) and PSS World Medical (NASDAQ: PSSI). Truveris will use the new funds to expand the development and operations teams to reach government entities, health insurance companies, self-insured corporations and unions across the United States.
“Truveris offers a true innovation for payers of pharmacy benefits by allowing real-time review of prescription claims billing, a process traditionally plagued with inefficiencies,” said Philippe Chambon, managing director, New Leaf Venture Partners. “Even minor billing errors, when magnified over millions of claims, can result in substantial costs to companies and ultimately the entire healthcare system. Truveris real-time bill review technology allows firms to stop overcharges while meeting CMS guidelines for Medicare-eligible pharmacy benefits and thereby reducing potential liabilities for not meeting compliance.”
Americans spend in excess of $307 billion a year on prescription drugs. By serving as an intermediary among pharmacies, drug manufacturers and employers, Pharmacy Benefit Managers (PBMs) can secure favorable pricing for payers to minimize spending. Truveris, through its TruBid product, helps these payers - insurance companies and self-insured organizations - drive up to 12 percent savings annually by making their request for proposals to PBMs through an automated, Web-based software program, creating a reverse auction through the cloud. Setting up benefits plans is an arduous task. This approach, which can be implemented directly or through brokers, cuts the PBM selection time in half, ensures standard contract terms, enforces drug pricing definitions and establishes consistent benchmarks through an automated process. Once health plan administrators have established a billing system with their PBM, TruGuard will catch billing errors in real-time. TruGuard enables payers with existing PBM contracts to verify and pay only for correctly priced and adjudicated claims, prior to payment, rather than relying on a manual, annual, less efficient retrospective audit.
“We are bringing cost effective technology solutions to an industry and process that desperately needs them,” said Bryan Birch, chairman, president and CEO, Truveris. “Based on reviewing more than 100 million claims through our software-as-a-service platform, we found that health plan administrators are being overcharged on every bill. This new round of funding is a validation from the investor community and industry professionals that this is an addressable issue.”
Bryan Birch remains the non-executive chairman of the board of Touchstone Health Plans, a Medicare Advantage Heath Plan operating in 11 New York State counties. Earlier this year, he was invited to present at the UBS 22nd Annual 2012 Global Healthcare Services Conference along side companies including Aetna (NYSE: AET), WellPoint (NYSE: WLP), Cigna (NYSE: CI), McKesson (NYSE: MCK) and Walgreens (NYSE: WAG). Birch brings more than 20 years of domain experience that includes senior executive roles at Medco Health Solutions, Empire Blue Cross Blue Shield and Oxford Health Plans.